Surgical cleaning tool, systems, and methods

This application is a continuation of U.S. patent application Ser. No. 16/984,490, filed on Aug. 4, 2020, and entitled “Surgical Cleaning Tool, Systems, and Methods,” the entire disclosure of which is incorporated herein by reference in its entirety.

The present technology is generally related to surgical tools, and is more specifically related to tools for anatomical surface preparation.

During a surgical procedure, and in particular during a spinal interbody fusion, surgical cleaning tools, such as brushes, may be used to prepare a surface of an anatomical element for the procedure or for a particular step thereof. A surgical robot may be used to assist with or autonomously carry out one or more steps of a surgical procedure.

Exemplary aspects of the present disclosure include:

A surgical tool according to at least one embodiment of the present disclosure comprises: at least one brush disposed on a shaft extending through a tube, the tube having a corresponding brush slot for each brush; a motor operable to rotate the shaft to cause the at least one brush to move from a closed position to a cleaning position, the at least one brush positioned entirely inside of the tube when in the closed position and at least partially outside of the tube when in the cleaning position; and a fluid source operable to supply fluid to the at least one brush as the at least one brush passes through the brush slot.

Any of the aspects herein, wherein the fluid is supplied through a conduit of the shaft.

Any of the aspects herein, wherein the at least one brush defines a substantially circular shape having a brush axis parallel to and offset from a shaft axis of the shaft, and rotation of the shaft causes the at least one brush axis to orbit around the shaft axis.

Any of the aspects herein, wherein the tube comprises a first conduit parallel to a second conduit, and wherein each of the at least one brush axis and the shaft axis are parallel to and offset from an axis of the second conduit.

Any of the aspects herein, further comprising a suction conduit for evacuating the fluid.

Any of the aspects herein, further comprising at least one evacuation slot disposed near the at least one brush slot, the at least one evacuation slot in communication with the suction conduit.

Any of the aspects herein, wherein as the at least one brush passes through the corresponding brush slot from the cleaning position to the closed position, the fluid and the corresponding evacuation slot evacuate the fluid from the at least one brush.

Any of the aspects herein, wherein the at least one brush comprises a plurality of steel bristles of varying lengths.

Any of the aspects herein, wherein the plurality of steel bristles forms a circle.

Any of the aspects herein, wherein the at least one brush comprises three brushes.

Any of the aspects herein, further comprising an elevation motor configured to vertically move the tool during operation of the tool.

A method for brushing an anatomical element according to at least one embodiment of the present disclosure comprises: causing at least one brush of the surgical tool to alternately rotate between a cleaning position and a closed position, the at least one brush positioned entirely within a perimeter of a tube of the surgical tool when in the closed position, the tube having a corresponding slot for each brush; causing a fluid source of the surgical tool to supply a fluid to the at least one brush from a fluid source as the at least one brush rotates through the closed position; and evacuating the fluid from the at least one brush through a suction conduit of the surgical tool, the suction conduit in fluid communication with an evacuation slot disposed near the slot.

Any of the aspects herein, wherein the brush is disposed on a shaft extending through the tube, the shaft comprising a bore and at least one fluid aperture positioned near the at least one brush, the fluid supplied to the at least one brush through the bore and the at least one fluid aperture.

Any of the aspects herein, further comprising: vertically moving the tool using a motor during operation of the tool.

Any of the aspects herein, wherein the at least one brush comprises a plurality of steel bristles of varying lengths.

A system for cleaning an anatomical space, according to at least one embodiment of the present disclosure comprises: at least one surgical tool comprising at least one brush, a corresponding slot for each brush, and a fluid source; a processor; and a memory storing instructions for execution by the processor that, when executed, cause the processor to: cause the at least one brush of the surgical tool to rotate between a cleaning position and a closed position, the at least one brush contacting the anatomical element when in the cleaning position; cause the fluid source to supply a fluid to the at least one brush, wherein as the at least one brush passes through the corresponding brush slot from the cleaning position to the closed position, the fluid and the corresponding brush slot evacuate loose anatomical elements from the at least one brush; and evacuate the fluid and the loose anatomical elements from the at least one brush.

Any of the aspects herein, wherein the at least one brush comprises a plurality of steel bristles of varying lengths.

Any of the aspects herein, wherein the instructions for execution by the processor, when executed, further cause the processor to cause a motor to vertically move the tool during operation of the tool.

Any of the aspects herein, wherein the surgical tool comprises a shaft, the at least one brush disposed on the shaft.

Any of the aspects herein, wherein the at least one brush defines a substantially circular shape having a brush axis parallel to and offset from a shaft axis of the shaft, rotation of the shaft causes the at least one brush axis to orbit around the shaft axis.

The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.

1 n 1 m 1 o 1 2 1 o The phrases “at least one”, “one or more”, and “and/or” are open-ended expressions that are both conjunctive and disjunctive in operation. For example, each of the expressions “at least one of A, B and C”, “at least one of A, B, or C”, “one or more of A, B, and C”, “one or more of A, B, or C” and “A, B, and/or C” means A alone, B alone, C alone, A and B together, A and C together, B and C together, or A, B and C together. When each one of A, B, and C in the above expressions refers to an element, such as X, Y, and Z, or class of elements, such as X-X, Y-Y, and Z-Z, the phrase is intended to refer to a single element selected from X, Y, and Z, a combination of elements selected from the same class (e.g., Xand X) as well as a combination of elements selected from two or more classes (e.g., Yand Z).

The term “a” or “an” entity refers to one or more of that entity. As such, the terms “a” (or “an”), “one or more” and “at least one” can be used interchangeably herein. It is also to be noted that the terms “comprising”, “including”, and “having” can be used interchangeably.

The preceding is a simplified summary of the disclosure to provide an understanding of some aspects of the disclosure. This summary is neither an extensive nor exhaustive overview of the disclosure and its various aspects, embodiments, and configurations. It is intended neither to identify key or critical elements of the disclosure nor to delineate the scope of the disclosure but to present selected concepts of the disclosure in a simplified form as an introduction to the more detailed description presented below. As will be appreciated, other aspects, embodiments, and configurations of the disclosure are possible utilizing, alone or in combination, one or more of the features set forth above or described in detail below.

Numerous additional features and advantages of the present invention will become apparent to those skilled in the art upon consideration of the embodiment descriptions provided hereinbelow.

It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example or embodiment, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the methods of this disclosure may be performed by a combination of units or modules associated with, for example, a computing device and/or a medical device (including a medical imaging device).

In one or more examples, one or more steps of the described methods, processes, and techniques may be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions may be stored as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. Computer-readable media may include non-transitory computer-readable media, which corresponds to a tangible medium such as data storage media (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer).

Instructions may be executed by one or more processors, such as one or more digital signal processors (DSPs), general purpose microprocessors (e.g., Intel Core i3, i5, i7, or i9 processors; Intel Celeron processors; Intel Xeon processors; Intel Pentium processors; AMD Ryzen processors; AMD Athlon processors; AMD Phenom processors; Apple A10 or 10X Fusion processors; Apple A11, A12, A12X, A12Z, or A13 Bionic processors; or any other general purpose microprocessors), application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry. Accordingly, the term “processor” as used herein may refer to any of the foregoing structure or any other physical structure suitable for implementation of the described techniques. Also, the techniques could be fully implemented in one or more circuits or logic elements.

Before any embodiments of the disclosure are explained in detail, it is to be understood that the disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Further, the present disclosure may use examples to illustrate one or more aspects thereof. Unless explicitly stated otherwise, the use or listing of one or more examples (which may be denoted by “for example,” “by way of example,” “e.g.,” “such as,” or similar language) is not intended to and does not limit the scope of the present disclosure. Similarly, the term “exemplary” as used herein means “example.” Also, unless explicitly stated otherwise, terms such as “about” and “approximately” when used in connection with a stated value mean within ten percent of the stated value.

Disc removal is a critical step in spinal interbody fusion. Some of the challenges of disc removal include that disc removal currently takes significant time and is often incomplete (e.g., the interbody space is not thoroughly cleaned of all disc remnants), leading to a risk of non-fusion. The nucleus pulposus, or inner core of the vertebral disc, is a sticky material not easily removed. Forceps can be used for some bulk reduction (e.g., removal of larger segments of the disc), but cannot clean the end plates sufficiently. Brushes are often used for end plate preparation, but each can be used only a single time, as cleaning the brushes (e.g., to remove the sticky nucleus pulposus material from the brush's bristles) is impractical. Thus, use of multiple brushes may be required for disc removal. With forceps and/or brushes, the removal and cleaning process is lengthy and incomplete. Moreover, many in-out maneuvers are required, endangering neutral tissue. Attempted mechanical solutions for disc removal have failed, at least in part due to an inability to overcome such problems as the stickiness of the material being removed, clogging suction tubes, and smoothing burring surfaces.

The solution described herein comprises a rotating brush to remove disc material, coupled with an integrated cleaning mechanism. The eccentric brush at its closed configuration is in the form of a tube, so as to allow a clean entry to the disc. The eccentric brush spins and cleans the end plate, then goes through a thin slot in the cleaning tool that wipes the brush and, by doing so, cleans the brush at every single spin. In order to remove solid matter dislodged from the end plate and from the brush, the cleaning tool includes an irrigation and vacuum system.

Embodiments of the present disclosure may be particularly useful, for example, during surface preparation in connection with spinal interbody fusion.

Inclusion of a slot, irrigation system, and vacuum system increases the life of a brush and reduces the need to use multiple brushes for one procedure, while also reducing and/or eliminated time associated with changing brushes and reducing or eliminating multiple entries and exits of cleaning tools to the surgical site, thus better protecting neutral tissue from unnecessary damage. The brush may also be sterilized and is thus reusable.

Embodiments of the present disclosure also provide a brush housed in a tube during positioning of the brush for cleaning, thereby protecting the brush (as well as neutral tissue along the insertion path) from damage. Tools according to embodiments of the present disclosure are also advantageously small and non-intrusive, and may be suitable for minimally invasive procedures.

As described more fully below, a cleaning tool according to at least some embodiments of the present disclosure may be designed to clean an anatomical element with a brush that moves between a cleaning position and a closed position, a fluid supply that supplies fluid to the brush to clean the brush, and an evacuation conduit for evacuating the fluid and loose anatomical particles from the anatomical element and/or the volume in proximity thereto.

1 1 FIGS.A andB 5 FIG. 5 FIG. 5 FIG. 5 FIG. 100 102 104 106 108 520 522 100 100 108 520 522 100 100 110 112 100 504 504 With reference first to, a cleaning toolaccording to at least one embodiment of the present disclosure comprises a tube, a brush set, a brush motor, an elevation motor, a fluid source(shown in), and a vacuum source(shown in). In some embodiments, the toolmay have fewer components or more components. For example, the toolmay not include the elevation motor, the fluid source, and/or the vacuum source(shown in). The toolmay be used to prepare a surface of an anatomical element (which may be, for example, a vertebral endplate) using a single, reusable brush or brush set. The toolincludes a proximal portionopposite a distal portion. The toolmay be held by a robot, as described with respect to, by a passive tool holder, or by a surgeon or other human, and may automatically (e.g., under control of the robot) or manually (e.g., under control of a surgeon) perform each step described herein.

100 102 102 114 116 118 120 114 116 102 102 102 102 102 In the illustrated embodiment, the toolincludes the tube. The tubeincludes a first conduitwith a first axis parallel to a second axis of a second conduit, and also includes a first endopposite a second end. The first conduitmay have a diameter less than, greater than, or equal to a diameter of the second conduit. The tubemay be any solid material including, but not limited to, metal, steel, plastic, or the like, or any combination thereof, and may be biocompatible. In some embodiments the tubemay have a diameter shaped for minimally invasive procedures for insertion into small incisions. For example, the diameter of the tubemay be 8 mm, though in other examples the tubemay have a diameter less than or greater than 8 mm. In other embodiments, the tubemay have a larger diameter.

104 102 122 122 104 122 118 122 102 120 124 102 122 104 104 122 122 104 The brush setcan include one brush, two brushes, or more than two brushes. The tubemay include a brush slot set. The brush slot setmay include one slot, two slots, or more than two slots, with the number of slots corresponding to the number of brushes in the brush set. In the illustrated embodiment, the brush slot setcomprises three slots positioned near the first end. In other embodiments, the brush slot setmay be positioned anywhere on the tube, for example, at or near the second endor near a midportionof the tube, depending on the particular anatomy being cleaned and from which anatomical particles are being evacuated. In the illustrated embodiment, each slot of the brush slot sethas a height substantially similar to or slightly larger than a height of each brush of the brush setsuch that loose anatomical particles that may be stuck on each brush of the brush setare dislodged by contact with the edges of the corresponding slot of the brush slot set. In other embodiments, each slot of the brush slot setmay have a height larger than the corresponding brush of the brush set.

102 126 102 122 122 102 102 120 124 102 126 102 122 126 122 126 104 100 116 The tubemay also include one or more evacuation slots. In the illustrated example, the tubeincludes a first evacuation slot disposed above the brush slot setand a second evacuation slot disposed below the brush slot set. In other embodiments, the tubemay include one evacuation slot or more than two evacuation slots. In further embodiments, the one or more evacuation slots may be disposed anywhere on the tube, for example, at or near the second endor near the midportionof the tube, depending on the particular anatomy being cleaned and from which anatomical particles are being evacuated. In the illustrated embodiment, the one or more evacuation slotsextend partially around a circumference of the tubeand have a height greater than the height of a slot of the brush slot set. In other examples, the one or more evacuation slotsmay fully extend around the circumference of the tube and/or may have a height greater than or less than the height of a slot of the brush slot set. The one or more evacuation slotsmay be sized to facilitate entry therethrough of anatomical particles dislodged by the brush setduring operation of the cleaning tool, and may further be sized to reduce a likelihood of being clogged by a plurality of anatomical particles being pulled into the second conduitat once.

106 110 128 104 104 102 104 104 104 102 104 104 104 102 The brush motoris disposed near the proximal portionand is operable to rotate a shaftto cause the brush setto rotate from a closed position to a cleaning position and back to the closed position. The closed position is the position in which the greatest portion of the brush setis enclosed within a perimeter of the tube, while the cleaning position is any rotational position of the brush setother than in the closed position. In other words, the cleaning position encompasses any angular offset of the brush setfrom the closed position (e.g., between 1 and 359 degrees offset from the closed position). In embodiments where the brush setis entirely contained within a perimeter of the tubewhen the brush setis in the closed position, the cleaning position encompasses any position of the brush setin which any portion of the brush setextends beyond a perimeter of the tube.

106 130 128 108 110 100 100 132 134 130 134 108 132 134 108 100 108 100 104 The brush motorin the illustrated embodiment is positioned on a motor bracketand coupled to the shaft. The elevation motoris also disposed near the proximal portionand is configured to vertically move the toolbefore, during, or after operation of the tool. In the illustrated embodiment, an elevation camextends through a cam slotin the motor bracketand slides along the cam slotwhen the elevation motorrotates. The camand the cam slottranslate the rotational movement of the elevation motorto a translational movement (e.g., vertical) of the tool. Operation of the elevation motorduring operation of the cleaning toolbeneficially enables the brush setto clean an entirety (or at least a significant portion) of an interbody disc space, despite having a substantially planar profile.

106 108 128 104 100 106 108 106 108 106 108 The brush motorand the elevation motormay be of the same or a different motor type than each other. In some embodiments, one or more gears, gear boxes, clutches, transmissions, and/or other mechanical elements may be utilized to enable a single motor to be used both to spin the shaftand thus the brush set, and to adjust the elevation of the tool. The brush motorand/or the elevation motormay be an electric motor, a pneumatic motor, a hydraulic motor, or another type of motor. In some embodiments, the brush motorand the elevation motoreach comprise a gear motor. In other embodiments, each of the brush motorand the elevation motorcomprise any type of motor including, but not limited to, an AC brushless motor, a DC brushed motor, a DC brushless motor, a servo motor, or the like.

2 2 FIGS.A-C 2 FIG.B 104 104 128 112 128 114 102 104 104 116 128 104 illustrate the brush setin detail. The brush setis positioned on the shaftnear the distal portion. The shaftextends through the first conduitof the tubeand has a shaft axis S parallel to (and, in some embodiments, coaxial with) the first conduit axis. The brush sethas a brush axis B at a center of the brush setthat is parallel to and offset from the shaft axis S and the first conduit axis, as shown in. The brush axis B is parallel to the second conduit axis of the second conduit. Rotation of the shaftcauses the at least one brush axis B to orbit around the shaft axis S, thereby causing eccentric rotation of the brush set.

104 128 104 128 104 128 104 128 128 100 104 128 128 The brush setand the shaftmay be a single piece (e.g., may be integrally formed), or separate pieces. In embodiments where the brush setis separate from the shaft, the brush setas a whole or the individual brushes thereof may be removable from the shaftfor replacement and/or cleaning. In other embodiments, the brush setis fixed to the shaftand the shaftis removable from the toolfor cleaning and/or replacement. In further embodiments, the brush setmay be fixed to a portion of the shaft, and the portion may be removeable from the shaftfor cleaning and/or replacement.

104 104 104 104 104 In the illustrated example, the brush setcomprises three brushes spaced apart from each other. In other examples, the brush setcomprises one brush, two brushes, or more than three brushes. In examples where the brush setcomprises two or more brushes, each brush may be spaced from or adjacent to another brush. The brush setmay have a height substantially similar to a height of a spinal disc, though the brush setmay have a height less than or greater than a height of a spinal disc

104 104 104 104 102 104 104 102 2 FIG.B In some embodiments, the brush setcomprises a plurality of steel bristles of varying length. In other embodiments, the brush setmay comprise bristles of any type of material including, but not limited to plastic, metal, synthetic fibers, natural fibers, or the like. As shown in, the brush setdefines a substantially circular shape when viewed from the top or bottom. More specifically, the plurality of bristles form a circle. In other embodiments, the brush setmay define any shape including, but not limited to, a square, a triangle, an oval, a rectangle, a star, or the like. In such embodiments, the tubemay be provided with the same or a similar shape, so that the brush setmay rotate into a closed position in which the brush setfits within an outer perimeter of the tube.

104 104 104 102 104 104 102 104 122 520 122 104 112 4 FIG.A As previously described, the brush setis movable from a closed position to a cleaning position. When the brush setis in the closed position, the brush setis positioned entirely inside of the tube, as shown in. When the brush setis in the cleaning position (or in any position other than the closed position), the brush setis at least partially outside of the tube. During use, when each brush of the brush setpasses through the corresponding brush slot of the brush slot setwhile rotating into or through the closed position, the fluid (from the fluid source, if used) and the corresponding brush slot of the brush slot setfacilitate dislodgment and evacuation of loose anatomical particles and/or fluid from each brush of the brush setas well as the interbody space into which the distal portionextends.

520 128 128 140 110 128 138 112 140 128 140 128 110 520 2 2 FIGS.A andC The fluid is supplied from the fluid sourcethrough a conduit of the shaft. As shown in, the fluid enters the shaftthrough one or more first fluid aperturesproximate the proximate portionand exits the shaftthrough one or more second fluid aperturesproximate the distal portion. In the illustrated embodiment, the one or more first fluid aperturescomprise a plurality of first fluid apertures positioned at or proximate a top end or top end portion of the shaft. In other embodiments, the one or more first fluid aperturescomprise a single aperture. The one or more first fluid apertures may be positioned anywhere on the shaft, although positioning the one or more first fluid apertures closer to the proximate portionmay facilitate the provision of fluid thereto from a fluid source.

138 128 104 128 138 104 138 104 138 104 138 138 128 The one or more second fluid apertures, as shown in the illustrated example, comprise a plurality of second fluid apertures positioned at a bottom end or bottom end portion of the shaftand adjacent to the brush set. In the illustrated embodiment, the shaftcomprises a first set of second fluid aperturespositioned on a proximate side of each brush of the brush set, and a second set of a second fluid aperturespositioned on a distal side of each brush of the brush set. Such positioning of the second fluid aperturesbeneficially enables fluid to be sprayed or otherwise discharged onto both sides of each brush of the brush set. In other embodiments, however, the second fluid aperturesmay be positioned only on a proximate side of each brush, or only on a distal side of each brush, or at the same elevation as each brush. In other embodiments, the one or more second fluid aperturesmay be positioned anywhere on the shaft.

3 3 FIGS.A andB 100 104 140 142 141 141 128 128 141 138 104 104 102 140 102 128 142 141 112 100 138 illustrate further details of the toolfor supplying fluid to the brush set. Fluid is supplied to the one or more first fluid aperturesvia a fluid tubeand a fluid ring. The ringadvantageously supplies fluid to the shaftwhile also allowing the shaftto rotate within the ring. As illustrated and described above, the second fluid aperturesare positioned on a proximate side and a distal side of each brush of the brush setto enable fluid to be sprayed or otherwise discharged onto both side of each brush of the brush set. In some embodiments, the tubemay include one or more first fluid tube apertures corresponding to the one or more first fluid apertures(e.g., in embodiments in which the tubeextends along a greater portion of the shaft, or where the fluid tubeand fluid ringare positioned closer to the distal portionof the tool) and one or more second fluid tube apertures corresponding to the one or more second fluid apertures.

4 4 FIGS.A-C 4 FIG.A 4 4 FIGS.A andB 4 4 FIGS.C-F 104 104 128 104 102 104 102 104 138 116 104 104 122 102 104 102 104 Turning to, the brush setis shown moving from a closed position to a cleaning position during use. The brush setmay be continuously rotated (e.g., by continuous rotation of the shaft) between the cleaning position and the closed position to clean an anatomical element by alternately brushing the anatomical element (when in the cleaning position) and being cleaned of anatomical particles through a combination of fluid spray and suction (when in the closed position). As previously described, the brush setis positioned inside of the tubewhen in the closed position, as shown in. In other words, the brush setis positioned entirely within a perimeter of the tubewhen in the closed position, in which position the brush setcan advantageously be cleaned by discharge of fluid from the second fluid aperturesthereon and by suction within the second or suction conduit. As the brush setmoves towards the cleaning position, as shown in(the cleaning position is shown, for example, in), the brush setrotates through the brush slot setand out of the tube. As the brush setrotates out of the tubeand through a complete rotation, the brush setscrapes or brushes anatomical particles from the anatomical element to clean the surface of the anatomical element from anatomical particles (e.g., from a disc being removed).

104 104 122 104 104 138 104 104 102 138 104 104 122 104 122 102 4 FIG.F When the brush setmoves from the cleaning position back to the closed position to complete a full rotation, as shown in, the brush setmoves through the brush slot set. Whether throughout the rotation or only as the brush setrotates through the closed position, fluid may also be supplied to the brush set(e.g., via the second fluid apertures) to loosen and/or dislodge anatomical particles that may be stuck to the brush setand/or prevent loose anatomical particles from becoming lodged in or stuck to the brush set. In some embodiments, the tubeblocks the second fluid apertureswhen the brush setis not in or close to the closed position, thus beneficially preventing fluid from being sprayed or discharged into the interbody space being cleaned. Further, as the brush setmoves through the brush slot set, the loose anatomical particles that may be stuck to each brush of the brush setmay be pushed off each brush when the loose anatomical particles contact an edge of the corresponding brush slot of the brush slot setor the tube.

126 122 116 522 116 126 116 As shown and previously described, one or more evacuation slotsare disposed near the brush slot setand in communication with the second conduit, also referred to as a suction conduit. The vacuum sourcecreates a suction in the second conduitor the suction conduit, and as the loose anatomical particles are dislodged, the suction draws the loose anatomical particles (and surrounding fluid) through the evacuation slotsand through the second conduitor suction conduit.

126 122 122 126 122 122 126 100 126 100 126 116 144 144 1 1 FIGS.A andB In the illustrated embodiment and as previously described, a first evacuation slotmay be disposed above the brush slot set(e.g., on a proximal side of the brush slot set) and a second evacuation slotmay be disposed below the brush slot set(e.g., on a distal side of the brush slot set). Inclusion of two evacuation slotsbeneficially facilitates evacuation of loose anatomical particles and fluid from the interbody space. Moreover, when the toolis moved upwards or away from the anatomical element, loose anatomical particles (and surrounding fluid) may be evacuated more readily through the second evacuation slotand when the toolis moved downwards or towards the anatomical element, loose anatomical particles (and surrounding fluid) may be evacuated more readily through the first evacuation slot. Also, as shown in the illustrated embodiment, the second conduitor suction conduit is connected to a vacuum tube, shown in, through which the loose anatomical particles are suctioned. Though not shown, the vacuum tubemay be connected to a receptacle or waste disposal to receive and/or dispose of the loose anatomical particles and/or fluid.

100 100 100 100 100 100 Each of the various components of the toolmay be made of a metal, a metal alloy, a plastic, a composite, any other suitable material that enables the component to achieve the purpose thereof as described herein, and/or any combination of the foregoing. In some embodiments, one or more components of the toolmay be made of a radiolucent material, such as polyetheretherketone (PEEK) or thermoplastic resins with carbon-fiber reinforcement. In other embodiments, none of the components of the toolare radiolucent. The material(s) from which the various components of the toolare made may be selected to enable the tooland/or one or more portions thereof to be cleanable, sterilizable (whether by heat, chemical treatment, or otherwise), and/or reusable. Additionally and/or alternatively, the material(s) from which the various components of the toolare made may be selected for ease of cleaning, replaceability, or repair.

100 500 100 500 500 502 504 100 520 522 506 500 500 500 506 500 520 522 1 4 FIGS.-F 5 FIG. 5 FIG. 5 FIG. 5 FIG. A tool, as described above with respect to, may be used in a system, as shown in, though it will be understood that the toolmay be used independently of the system. The systemincludes a computing device, a robot(which may include or be holding the tool), a fluid source, a vacuum source, and/or a navigation system. In some embodiments of the present disclosure, systems such as the systemofmay not include one or more of the illustrated components, may include other components not shown in, and/or may include components similar to, but not the same as, one or more components of the systemshown in. For example, in some embodiments, the systemmay not include the navigation system. In other embodiments, the systemmay not include the fluid sourceand/or the vacuum source.

502 508 510 512 514 502 502 5 FIG. The computing deviceaccording to embodiments of the present disclosure may comprise a processor, a memory, a communication interface, and the user interface. A computing device such as the computing devicein some embodiments may have more components or fewer components than the computing deviceshown in.

508 502 508 510 508 514 100 502 506 The processorof the computing devicemay be any processor described herein or any similar processor. The processormay be configured to execute instructions stored in the memory, which instructions may cause the processorto carry out one or more computing steps utilizing or based on data received from the user interface; one or more sensors included in, attached to, or otherwise monitoring operation of the tool; the computing device, and/or the navigation system.

510 510 600 510 516 518 516 516 508 600 504 506 100 520 522 516 508 510 506 The memorymay be or comprise RAM, DRAM, SDRAM, other solid-state memory, any memory described herein, or any other tangible, non-transitory memory for storing computer-readable data and/or instructions. The memorymay store information or data useful for completing any step of the methoddescribed herein. The memorymay store, for example, one or more instructionsand/or one or more surgical plans. Such instructionsmay, in some embodiments, be organized into one or more applications, modules, packages, layers, or engines. The instructionsmay be configured for execution by the processorto carry out any method described herein (including the method) or portion thereof, and/or to operate one or more of the robot, the navigation system, the tool, the fluid source, and/or the vacuum source. The instructionsmay cause the processorto manipulate data stored in the memoryand/or received from the navigation system.

502 512 512 100 504 506 100 504 506 512 512 502 508 502 The computing devicemay also comprise a communication interface. The communication interfacemay be used for receiving information from an external source (such as the tool, the robot, and/or the navigation system), and/or for transmitting instructions, data, or other information to an external system or device (e.g., the tool, the robot, and/or the navigation system). The communication interfacemay comprise one or more wired interfaces (e.g., a USB port, an ethernet port, a Firewire port) and/or one or more wireless interfaces (configured, for example, to transmit information via one or more wireless communication protocols such as 802.11a/b/g/n, Bluetooth, NFC, ZigBee, and so forth). In some embodiments, the communication interfacemay be useful for enabling the computing deviceto communicate with one or more other processorsor computing devices, whether to reduce the time needed to accomplish a computing-intensive task or for any other reason.

502 514 514 514 100 104 104 104 116 112 100 516 518 504 524 100 516 518 514 516 518 500 508 500 500 500 The computing devicemay also comprise one or more user interfaces. The user interfacemay be or comprise a keyboard, mouse, trackball, monitor, television, touchscreen, joystick, switch, button, headset and/or any other device for receiving information from a user and/or for providing information to a user. The user interfacemay be used, for example, to receive a user selection or other user input regarding controlling a robot to position the toolwithin an interbody space; a user selection or other user input regarding causing the brush setto rotate between a cleaning position and a closed position in an alternating fashion; a user selection or other user input regarding causing a fluid source to supply a fluid to the brush set; a user selection or other user input regarding evacuating fluid from the brush setthrough the suction conduit; a user selection or other user input regarding adjusting an elevation of the distal portionof the tool; to receive user input useful in connection with the instructionsand/or the surgical plan, to receive a user selection or other user input regarding operation of the robot, manipulation of the robotic arm, and/or use of the tool; and/or to display the instructionsand/or the surgical plan. In some embodiments, the user interfacemay be useful to allow a surgeon or other user to modify the instructions, the plan, or other information displayed, though it will be appreciated that each of the preceding inputs may be generated automatically by the system(e.g., by the processoror another component of the system) or received by the systemfrom a source external to the system. In some embodiments, user input such as that described above may be optional or not needed for operation of the systems, devices, and methods described herein.

514 502 502 514 502 514 502 514 502 Although the user interfaceis shown as part of the computing device, in some embodiments, the computing devicemay utilize a user interfacethat is housed separately from one or more remaining components of the computing device. In some embodiments, the user interfacemay be located proximate one or more other components of the computing device, while in other embodiments, the user interfacemay be located remotely from one or more other components of the computing device.

504 504 504 524 524 524 100 524 100 524 504 The robotmay be any surgical robot or surgical robotic system. The robotmay be or comprise, for example, the Mazor X™ Stealth Edition robotic guidance system. The robotmay comprise one or more robotic arms. In some embodiments, the robotic armmay comprise one robotic arm, though in other embodiments, the robotic armmay comprise two robotic arms or more than two robotic arms. The toolmay be disposed on an end of the robotic arm. In other examples, the toolmay be disposed on any portion of the robotic armand/or the robot.

500 506 500 506 506 506 506 524 524 506 506 506 506 504 100 500 500 506 In some embodiments, the systemmay include a navigation system, though in other embodiments, the systemmay not include a navigation system. The navigation systemmay provide navigation for a surgeon and/or a surgical robot during an operation. The navigation systemmay be any now-known or future-developed navigation system, including, for example, the Medtronic StealthStation™ S8 surgical navigation system. In various embodiments, the navigation systemmay be used to track a position of the robotic arm(or, more particularly, of a navigated tracker attached to the robotic arm). The navigation systemmay include a camera or other sensor(s) for tracking one or more reference markers, navigated trackers, or other objects within the operating room. The navigation systemmay include a display for displaying one or more images from an external source (e.g., a camera or other source) or a video stream from the camera or other sensor of the navigation system. In some embodiments, the navigation systemmay provide position, movement, and/or other information to the robotfor use in controlling the tooland/or any other aspect of the system. In some embodiments, the systemdoes not include and can operate without the use of the navigation system.

504 524 100 506 502 500 506 100 500 504 100 Reference markers (i.e., navigation markers) may be placed on the robot, the robotic arm, the tool, or any other object in the surgical space. The reference markers may be tracked by the navigation system, and the results of the tracking may be used by the computing deviceand/or by an operator of the systemor any component thereof. In some embodiments, the navigation systemcan be used to track other components of the system (e.g., the tool) and the systemcan operate without the use of the robot(e.g., with the surgeon manually manipulating the tool).

500 520 522 500 520 522 520 522 520 522 100 500 520 522 100 100 520 522 142 144 520 104 104 520 104 100 502 522 520 520 142 128 144 100 The systemmay also include the fluid sourceand/or the vacuum source. In some embodiments, the systemdoes not include the fluid sourceand/or the vacuum source, may include only the fluid source, or may include only the vacuum source. In other embodiments, the fluid sourceand/or the vacuum sourcemay be used with the toolindependently of the system. Each of the fluid sourceand/or the vacuum sourcemay be formed as a part of the toolor may be separate from the tool. A hose (not shown) may extend from each of the fluid sourceand the vacuum sourceto the fluid tubeand the vacuum tube, respectively. The fluid sourcemay be configured to provide fluid to the brush set. The fluid may be a gas (e.g., oxygen, air, carbon dioxide, heliox) or a liquid (e.g., water, saline, or another irrigant). The fluid may flush loose anatomical particles from the brush set, and/or anatomical element. The fluid sourcemay be configured with a pressurized fluid storage container or may otherwise comprise a pressurized fluid source so as to enable the fluid to be discharged onto the brush setunder pressure. In such embodiments, the pressure may be selectable (whether by a surgeon or other human operator of the tool, or by the computing device, or otherwise). The vacuum sourcemay remove the fluid when used with the fluid sourceand/or may remove loose anatomical particles when used with or without the fluid source. The fluid may be delivered to the anatomical element via the fluid tubeand the shaft, and/or removed from the anatomical element via the vacuum tube. In other embodiments, the fluid may be delivered to or removed from the anatomical element through or via any cannula, annulus, or hose formed on, disposed on, or connected to the tool.

6 FIG. 1 4 FIGS.A-C 5 FIG. 600 504 502 600 100 500 Turning now to, a methodfor performing a surgical procedure may be executed in whole or in part by a robot (e.g., the robotcontrolled by the computing device) and/or a surgeon. The methodmay be performed using, for example, the tooldescribed above with respect toand/or the systemdescribed above with respect to.

600 504 100 602 524 518 508 506 The methodcomprises controlling a robot, such as the robot, to position a cleaning tool, such as the tool, within an interbody space (step). The cleaning tool may be attached to a robotic arm such as the robotic arm. The controlling may include sending instructions to the robot for manipulating the robotic arm to insert the cleaning tool into an interbody space, and may be based on, for example, a surgical plan such as a surgical plan, one or more images of the anatomy of the patient into which the cleaning tool is being inserted, user input, and/or other information. The instructions may include a predetermined position and orientation of the cleaning tool. The controlling may include providing a trajectory or movement path from the surgical plan to the robot, or determining, with a processor such as the processor, a trajectory or movement path for the robot that will result in the cleaning tool being properly positioned within the interbody space, and then providing the determined trajectory or movement path to the robot. In some instances, the tool may be used manually by a surgeon, which surgeon may in some embodiments be assisted by the robot and/or a navigation system (e.g., the navigation system).

600 104 604 102 2 4 4 FIGS.B andA-C The methodalso comprises causing a brush set (e.g., the brush set) of the tool to rotate between a cleaning position and a closed position in alternating fashion (step). As described with respect to, the brush set is positioned entirely within a perimeter of a tube (e.g., the tube) of the tool when in the closed position. The tube may have a corresponding brush slot of a brush slot set through which each brush passes on each rotation. The brush set may dislodge or remove anatomical particles from an anatomical element to clean a surface of the anatomical element.

600 520 606 2 3 FIGS.A-B The methodalso comprises causing a fluid source (e.g., the fluid source) of the tool to supply a fluid to the brush set (step). As previously described with respect to, the fluid is supplied to each brush of the brush set as each brush rotates through the closed position. In some embodiments, the fluid is constantly supplied to the brush set. The fluid may prevent loose anatomical particles from sticking to the brush set and/or may loosen anatomical particles lodged in the brush set.

600 116 608 606 1 1 FIGS.A-B The methodfurther comprises causing the fluid (and any anatomical particles entrained therein) to be evacuated from the brush set though a suction conduit (e.g., the second conduit) of the tool (step). As previously described with respect to, the fluid and/or loose anatomical particles may be evacuated from the site through an evacuation slot disposed near the brush slot set. The evacuating may not result in complete removal of all of the fluid provided in the step. Further, loose anatomical particles may be dislodged as the brush set passes through the corresponding brush slot set to the closed position and the loose particles may be evacuated through the evacuation slot and the suction conduit. Rotation of the brush set between the cleaning position and the closed position may be continuously repeated until the surface of the anatomical element is sufficiently cleaned.

600 112 610 108 The methodfurther comprises causing an adjustment of an elevation of a distal portion, such as the distal portion, of the cleaning tool (step). The elevation of the cleaning tool may be adjusted via an elevation motor, such as the elevation motor. The elevation may be continuously adjusted or adjusted in discrete increments autonomously or under direction of the surgeon. By continuously adjusting the elevation of the distal portion, an elevation of the brush set is continuously adjusted during use to form a vibration motion, thereby facilitating thorough cleaning of the interbody space.

600 518 514 512 502 510 In some embodiments, the methodmay comprise receiving the surgical plan (e.g., the surgical plan). The surgical plan may be received via a user interface such as the user interfaceand/or a communication interface such as the communication interfaceof a computing device such as the computing device, and may be stored in a memory such as the memoryof the computing device. The surgical plan may include information about one or more planned movements of the tool (and/or of the robot holding the tool) during a surgical procedure. The information may also include a timeline or schedule of the one or more planned movements. The one or more planned movements may include one or more of timestamps, a type of movement (e.g., translational and/or rotational), a duration of the movement, and/or positional information (e.g., coordinates).

600 In some embodiments, the methodmay comprise determining information about one or more needed movements of the tool during a surgical procedure outlined or otherwise described in a surgical plan. In such embodiments, the surgical plan may not include receiving any such information via the computing device, but through the processor executing instructions stored in the memory, which may generate such information based on the surgical plan.

600 516 100 602 610 In some embodiments, the methodmay comprise generating instructions such as the instructionsfor causing the tool (e.g., the tool) to perform one or more surgical steps such as those described in connection with the stepsto. The instructions may be based on the surgical plan. In some embodiments, however, the tool may be automatically actuated based on instructions stored in a memory thereof that are not based on a surgical plan.

516 514 The instructionsmay include one or more instructions that cause an alert or other indication to be given to the surgeon (e.g., via a user interface such as the user interface) prior to each movement of the tool, and/or prior to executing one of the one or more planned surgical steps. In some embodiments, such an alert may pause execution of the surgical plan for approval by the surgeon or other operator. In other embodiments, the alert may simply notify the surgeon of the planned movement and/or of the planned volume increase or decrease, and automatically execute the planned movement. The alert and/or notification may be displayed on the user interface and/or may include a sound and/or a visual display.

6 FIG. 6 FIG. 600 600 As may be appreciated based on the foregoing disclosure, the present disclosure encompasses methods with fewer than all of the steps identified in(and the corresponding description of method), as well as methods that include additional or other steps beyond those identified in(and the corresponding description of method).

The methods and systems described herein provide a tool that can prepare a surface of an anatomical element for a fusion or other surgical procedure. The tool is self-cleaning and may be reusable, thereby eliminating the need for a surgeon or surgical robot to switch brushes during cleaning and resulting in reduced operating time and less trauma to the neutral tissue of the patient along the insertion/removal path. Further, a lack of switching brushes or tools reduces potential risk of accidental impact from a tool or brush being removed or inserted into the surgical site. The brush is also protected during positioning, thereby reducing risk of damage to the brush prior to cleaning of the anatomical element.

The foregoing discussion has been presented for purposes of illustration and description. The foregoing is not intended to limit the disclosure to the form or forms disclosed herein. In the foregoing Detailed Description, for example, various features of the disclosure are grouped together in one or more aspects, embodiments, and/or configurations for the purpose of streamlining the disclosure. The features of the aspects, embodiments, and/or configurations of the disclosure may be combined in alternate aspects, embodiments, and/or configurations other than those discussed above. This method of disclosure is not to be interpreted as reflecting an intention that the claims require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive aspects lie in less than all features of a single foregoing disclosed aspect, embodiment, and/or configuration. Thus, the following claims are hereby incorporated into this Detailed Description, with each claim standing on its own as a separate preferred embodiment of the disclosure.

Moreover, though the description has included description of one or more aspects, embodiments, and/or configurations and certain variations and modifications, other variations, combinations, and modifications are within the scope of the disclosure, e.g., as may be within the skill and knowledge of those in the art, after understanding the present disclosure. It is intended to obtain rights which include alternative aspects, embodiments, and/or configurations to the extent permitted, including alternate, interchangeable and/or equivalent structures, functions, ranges or steps to those claimed, whether or not such alternate, interchangeable and/or equivalent structures, functions, ranges or steps are disclosed herein, and without intending to publicly dedicate any patentable subject matter.